Vigilância sanitária nas capitais do sudeste brasileiro

Abstract

In Brazil, it is referred to as sanitary surveillance a complex state action that has undergone transformations since 1999, with the creation of the National Agency of Sanitary Surveillance (ANVISA) and the institution of the National Health Surveillance System (SNVS). Its area of activity covers the sanitary control of products and practices related to health, articulating to control some determinants, risks and damages to health. It represents an expressive part of health protection and, integrating the Brazilian Health System (SUS), contributes to its qualification, as well as national products submitted to sanitary regulation. In the organization of SNVS, notably in a federative country with continental dimensions and extremely diverse realities, such as Brazil, the decentralized implementation of actions and their correspondence with the loco regional context is fundamental. Being the municipality the most fragile component of the SNVS, it is imperative to study contextually the municipal services, and among them, the capitals, which concentrate resources, population and problems of various orders. This is an exploratory and descriptive study based on secondary and universal access data and covers sanitary surveillance services of the four state capitals of the southeastern region of Brazil, from 2014 to 2017, a year of reform of federal SUS financing. The capitals were characterized by sociodemographic and financial indicators and the respective sanitary surveillance services, using data from the Municipal Basic Information Survey, from the official sites and referring to their rates collection. The procedures reported by these services were described and their revenues and expenses analyzed. It was found that the sanitary surveillance of these capitals are inserted in different hierarchical levels in the organization chart of the respective SMS and that their financing is very dependent on federal transfers, which decreased in the period. The allocation of own resources was very low and amounts collected as fees and fines seems not to have been reverted to the service in one of the capitals that reported this collection. There was no uniformity in relation to the types of inspecteds establishments/activities and the licensing process. Data from the different databases were consistent. It is necessary elucidate to what type of regulation are being submitted the establishments and services located in the jurisdictional limit of the capitals and that are not regulated by them, and discuss responsibilities. As well as institutional and political factors, with the intention of explaining the non-allocation of own resources and those collected by the surveillance, or part of them, to the services themselves.